Apparatus and methods for rendering personal stories to medical patients

ABSTRACT

A health care apparatus ( 10 ) and methods are described for rendering audio visual content to a medical patient in the patient&#39;s home, in which a content element storage ( 22 ) stores a plurality of audio visual content elements ( 28 ) to be rendered to the patient in the patient&#39;s home, including personal story content elements ( 40 ) in which an interviewee ( 42 ) is shown discussing one or more issues related to the patient&#39;s medical condition. One or more content elements are selected according to a medical condition of a given patient and presented to the patient via a display device ( 14 ) of a user interface ( 12 ) located in the patient&#39;s home. Methods are presented for generating audio visual content for presentation to a medical patient in the patient&#39;s home in which a set of questions relating to a given medical condition is generated ( 102 ) and questions from the set are presented ( 104 ) to at least one interviewee, such as an actor or a person having the given medical condition. The interviewee&#39;s responses to the presented questions are recorded ( 106 ) and edited ( 108 ) to create a personal story content element which is then stored ( 110 ) in a content element storage coupled with a communications network from which content elements are selected for presentation to patients having the given medical condition.

The following relates to ongoing health care for patients with medicalconditions such as chronic illnesses, long term medical conditions, etc.In particular, this application involves provision of audio visualcontent including personal stories to medical patients, preferably inthe patient's home or other location remote from a health caregiver viaa secure, personalized platform service that connects patients that maynot be technologically savvy with their care team to facilitatehealthcare organizations effectively and efficiently empowering andassisting patients in managing their health and lifestyle despite thesometimes daunting prospect of dealing with modern technology. Theinventors have appreciated that treatment of a patient's medicalcondition can be aided by modification of the patient's behavior in oneor more respects, such as encouraging proper diet and/or exercise,cessation of undesired activities, etc, and further that peer groupfeedback can facilitate effective behavior modification programs. Inthis regard, it has been found that patients may respond positively topertinent information provided by others who are undergoing the sameexperiences in coping with the same or similar medical problems, andthat patients find hope in knowing that they are not alone and thatothers in the same circumstances have met with success in learningsimple techniques and strategies for getting along, and further thatpeer communication provides patients with moral support.

However, many patients with chronic diseases have limited mobility, andit may be difficult or impossible to get out and participate in livepeer group discussions, particularly on a regular basis. While on-linegroup discussions may be possible, many patients are unfamiliar with theInternet, such as elderly patients who are not well versed in navigatingelectronic media and thus may forego such opportunities. Memory loss isalso often an obstacle to providing care to elderly patients, wherecertain patients may benefit more from small amounts of information thanfrom participation in lengthy group discussions in which the topic maychange frequently. Moreover, certain information obtained in live groupsettings may be unhelpful or inaccurate, particularly remarks and/ormedical advice from non-professionals.

The present disclosure facilitates provision of the positive aspects ofpeer group feedback to medical patients while mitigating the abovenegative aspects of attending peer group meetings, particularly forpatients with limited ability to travel to live meetings or toparticipate in on-line sessions.

In accordance with one aspect, a health care apparatus is provided torender audio visual content to a medical patient. The apparatuscomprises a content storage coupled with a communications network wherethe content storage is adapted to store audio visual content elements tobe rendered to a medical patient, the content elements includingpersonal story elements that individually include an interviewee showndiscussing at least one issue related to a medical condition. Theapparatus further includes an itinerary arrangement system operativelycoupled with the content storage and adapted to select one or morecontent elements from the content storage including at least onepersonal story element to be rendered to the patient in a given viewingsession based at least partially on the patient's medical condition. Inaddition, the apparatus includes a user interface operatively coupledwith the network and with a display device, where the user interface isoperable by the patient to render the selected content elements to thepatient via the display device.

The apparatus advantageously provides the patient with the ability toview content specific video including peer group feedback in the form ofpersonal stories to enhance learning of information related to thepatient's medical condition and to facilitate effective behaviormodification. The personal story content can be provided along witheducational or informative content elements and with interactivesurvey/quiz content to reinforce the informational content and to aid ininformation retention. In this manner, the patient can receive relevantinformation in an interactive television program style setting whileremaining in their home and the patient also has the ability to selectdifferent presentation options including personal stories told bypersons who have encountered similar circumstances in dealing with anillness.

In another aspect, the itinerary arrangement system selects the personalstory element and at least one educational content element to berendered to the patient in a given viewing session and arranges theselected content in a serially ordered itinerary for presentation to thepatient with the personal story element presented to the patient afterthe educational content element. In this arrangement, the personal storycan be selected so as to reinforce the educational information providedin a preceding content element, where the personal rendition of thestory reiterates some or all of the informative content in the form of apersonalized response from a person with whom the patient shares acommon connection to enhance the learning experience while providing themotivational and credibility advantages of hearing the information froma person perceived by the patient as a peer. In other possibleimplementations, survey or quiz type content can be presented along witha personal story in a given viewing session, with the personal storypreferably following the survey. In this approach, the personal storycan be used to reiterate information related to the survey content. In arelated embodiment, the results of an interactive survey or quiz, suchas a patient's answer to a survey question, can be used in selecting apersonal story presented after the survey. The personal story may thusbe used to correct an incorrect answer in the form of a friendly,comforting story to indicate to the patient that others may havemisunderstood the same concept, and to relate how others with the sameor similar medical conditions have benefited from learning the concept.

In a further aspect, a method is provided for rendering health careinformation to a patient. The method includes storing audio visualcontent elements to be rendered to a medical patient in a contentelement storage coupled with a communications network, includingpersonal story elements individually including an interviewee showndiscussing at least one issue related to a medical condition. The methodfurther comprises selecting content elements from the content elementstorage at least partially according to the patient's medical condition,such as by an itinerary arrangement system coupled with the network, andrendering selected content elements to the patient via a display deviceof a user interface operatively coupled with the communications networkand located in the patient's home.

The content selection and arrangement can include arranging the selectedcontent elements for presentation with the personal story content afterone or both of educational and survey content elements, wherein one ormore personal story content elements can optionally be selected based atleast partially on a patient response to an interactive survey or quizcontent element in the viewing session. Certain embodiments of themethod, moreover, may include allowing the patient to select from a listof interviewees and selecting a personal story content element showingthe selected interviewee discussing at least one issue related to thepatient's medical condition. This may facilitate the patient's learningor behavior modification by having the story presented by a personhaving characteristics preferred by a particular patient, for example,where the interviewees may be characterized by gender, age group, orother group characteristic.

Another aspect is related to a method for generating audio visualcontent for presentation to a medical patient via a display device of auser interface located in the patient's home and operatively coupledwith a communications network. This method includes generating a set ofquestions relating to a given medical condition, and presentingquestions from the set to at least one interviewee, such as by amoderator experienced in encouraging responsiveness in a singleinterview or group setting. The interviewee responses are recorded andedited, for instance, to remove negative comments, incorrect medicalinformation, responses unrelated to a given medical condition orpersonal experience, etc., to create a personal story content elementand the personal story content is stored in a content element storagecoupled with a communications network from which content elements areselected for presentation to patients having the given medicalcondition. The interviewee can be a person who has or had the givenmedical condition, or can even be an actor who recreates the substanceof responses gleaned from actual patients, such that stories provided bycertain patients can be retold to improve grammatical portrayal, toprovide the story in a language other than the original interviewee'snative language, to provide the story in a dialect or accent more likethat of the viewing patient, etc.

This technique allows the end user patient to experience many or all ofthe advantages of participation in a focus group without having to leavetheir home, and without having to sit through a lengthy discussion thatmay involve extraneous or incorrect information.

Another advantage resides in expeditious and economical creation ofuseful personal story content using responses generated in a group typeenvironment, where the resulting personal story content elements can becategorized and incorporated into the above described content deliverysystems for scheduled initial presentation and subsequent recall by thepatient.

Still further advantages of the present disclosure will be appreciatedto those of ordinary skill in the art upon reading and understand thefollowing detailed description.

The present subject matter may take form in various components andarrangements of components, and in various steps and arrangements ofsteps. The drawings are only for purposes of illustrating preferredembodiments and are not to be construed as limiting the subject matter,wherein:

FIG. 1 is a schematic diagram illustrating an exemplary patienthealthcare apparatus network in which one or more aspects of the presentdisclosure may be implemented;

FIG. 2 is a flow diagram illustrating an exemplary method for creatingaudio visual personal story content elements for presentation to amedical patient in accordance with other aspects of the disclosure;

FIG. 3 is a flow diagram illustrating an exemplary method for renderingpersonal story content to a patient according to the disclosure;

FIG. 4 is a flow diagram illustrating exemplary operation of theapparatus of FIG. 1 in a guided encounter;

FIG. 5 is a schematic diagram illustrating an exemplary startup screenrendered to a patient using the apparatus of FIG. 1;

FIG. 6 is a schematic diagram illustrating an exemplary login screenrendered to a patient using the apparatus of FIG. 1;

FIG. 7 is a schematic diagram illustrating an exemplary welcome screenrendered to a patient using the apparatus of FIG. 1;

FIG. 8 is a schematic diagram illustrating an exemplary itinerary screenrendered to a patient using the apparatus of FIG. 1;

FIG. 9 is a schematic diagram illustrating an exemplary content overviewscreen rendered to a patient using the apparatus of FIG. 1;

FIG. 10 is a schematic diagram illustrating an exemplary content viewingscreen rendered to a patient using the apparatus of FIG. 1;

FIG. 11 is a schematic diagram illustrating an exemplary content saveoption screen rendered to a patient using the apparatus of FIG. 1;

FIG. 12 is a schematic diagram illustrating an exemplary itineraryscreen with a partially complete itinerary rendered to a patient usingthe apparatus of FIG. 1;

FIG. 13 is a schematic diagram illustrating an exemplary survey/quizquestion screen rendered to a patient using the apparatus of FIG. 1;

FIG. 14 is a schematic diagram illustrating an exemplary story tellerselection screen rendered to a patient using the apparatus of FIG. 1;

FIG. 15 is a schematic diagram illustrating an exemplary personal storyviewing screen rendered to a patient using the apparatus of FIG. 1;

FIG. 16 is a schematic diagram illustrating a different personal storyviewing screen with a different interviewee telling a story to thepatient using the apparatus of FIG. 1;

FIG. 17 is a schematic diagram illustrating an exemplary congratulatoryscreen rendered to a patient using the apparatus of FIG. 1;

FIG. 18 is a schematic diagram illustrating an exemplary navigationalmenu screen rendered to a patient using the apparatus of FIG. 1; and

FIG. 19 is a schematic diagram illustrating an exemplary userfeedback/selection screen rendered to a patient using the apparatus ofFIG. 1.

Referring now to the drawings, FIG. 1 schematically depicts an exemplaryhealth care apparatus 10 operable to present or render audio visualpersonal story content elements to medical patients. Patients with oneor more medical conditions often have lifestyle issues which complicatethe medical issues, for instance, improper diet, lack of exercise,obesity, smoking, etc. can aggravate diabetes or other medical problem.The apparatus 10 may be advantageously employed to assist patients inmanaging their disease, adjusting their lifestyle and other behaviormodification by providing each patient with personalized programmingthat can be presented in the patient's home or other convenient setting.In one exemplary implementation, the patient is provided with a careplan in the form of a series of educational or motivational programsdirected to healthcare issues specific to that particular patient andtheir medical condition(s), where the programs include one or morecontent elements 28. A given patient might be provided, for instance,with educational and motivational programming at the same time each dayto assist the patient in establishing and maintaining a diet andexercise regimen. The programming may be provided in any suitable formand format, such as a video disc (e.g., DVD or other format), from aprogramming memory, or from a central source, such as a content elementstorage of a networked server 22 operated by a hospital or medical carefacility that has prescribed the programming, and the content 28 istransferrable over and/or selectively operable via a publiccommunications network 20 to the patient's home. A set top box or otheruser operable interface 12 is provided in the patient's home, whichdecodes the signals intended for the specific patient and displays thecorresponding programming on the patient's television or other suitabledisplay device 14 operatively associated with the user interface 12. Thepatient can interact with the apparatus 10 using their TV or set top boxremote controller 16, where the set top box user interface 12 providesfor user feedback, such as weigh-ins, blood pressure readings, userselections, etc. to be communicated from the patient to the healthcarefacility. In other implementations, the apparatus 10 can be located in aclinic, hospital, school, work site, community center, or other publicplace.

In certain medical care situations, when a physician prescribes shortterm care such as a finite amount of prescription drugs, rest, and thelike, once the patient takes all the pills, etc., the treatment is inone sense complete. In other possible situations, however, the patientmay be diagnosed with a long term illness or chronic disease or othermedical condition that requires long term care and/or lifestyle changes.In this scenario, the healthcare professional may prescribe habits orbehaviors that were not previously a part of the patient's dailyregimen. Motivated by the visit with the doctor, the patient may startthe new treatment with good intentions, but may gradually fall back intothe prior lifestyle as time goes by. One illustrative example is fordiabetes sufferers, where a doctor instructs the patient to eat better,exercise more, and check their insulin levels regularly. Absent furtherdoctor visits or other reminders or motivations, the patient mayeventually revert to previous habits by forgetting to diet and exercise,and possibly foregoing regular glucose measurements.

The apparatus 10 may be advantageously employed in such situations tohelp keep chronic care patients motivated by providing a dynamic caregiving experience even long after any given visit to a doctor and toprovide health related feedback from the patient to the caregiver. Theapparatus 10 is comprised of one or more individual user interfacedevices 12, one of which is illustrated in FIG. 1, and which can be inthe form of a set top box, processor, or other such interface devicethat is operable by the patient user and which is operatively coupledwith the network 20. The user interface 12, moreover, is operativelyassociated with a display 14, such as the patient's television set, amonitor, or other display device by which audio visual content 28 can bepresented or rendered to the patient. In operation of one possibleimplementation, the patient logs on to the apparatus 10 via theinterface device 12, using a handheld remote control device 16, enteringinformation via one or more keys or buttons 18 thereof. The interface12, moreover, may be a separate set top box connected to the display 14via suitable cables as shown, or the display 14 may be integrated intothe interface 12. The interface device 12 interacts with the inputdevice 16, such as a handheld remote, touch screen, keyboard, mouse, orother similar device by which the patient can enter information, such aspasswords, responses to questions, health related readings such asweight or blood pressure, etc. The input device 16 may preferablyinclude large keys 18 with distinct markings such as color, shape,and/or labeling that clearly delineate the intended use or functionalityto a patient.

The interface device 12 is operatively coupled with the public network20, which can be any suitable network, whether wired or wireless orcombinations thereof, for example, such as an interactive cable TVnetwork, the internet, etc. Although acting over a public or privatenetwork 20, the user interface device 12 communicates with encryptedsignals over a secure layer of the network 20 to protect sensitiveinformation of the patient. The interface 12 communicates via thenetwork 20 with various servers such as a server 22 that is remote fromthe patient location and which preferably is operated by the patient'shealth care provider, hospital, associated service organization, etc.The exemplary server 22 is operative to store information and/or dataand in one example includes a memory such as a look-up-table or database24 of patient care plans that have been synthesized for all the patientsfor which this particular server 22 is responsible. A care plan ispreferably synthesized by a nurse manager, doctor, or other health careprofessional based on the patient's medical history. To create a careplan, the health care professional reviews the patient's medicalhistory, and inputs information to a generic care plan template. Thesystem also includes a content management system 25 for uploading,versioning, and previewing content for the health care professional. Thecontent management system 25 also includes a facility to experience whatthe patient would actually see before actually deploying the mediacontent 28 to the patients.

In one implementation, the health care professional inputs theinformation to a template via a user interface 26 operatively coupledwith the server 22. The templates act as road maps to direct the healthcare professional in developing the care plan, ensuring that allappropriate questions are addressed. In addition to the template, thehealth care professional can add features to the care plan based onphysician's notes, personality traits of the patient, etc., to furthertailor each care plan to an individual patient. The patient's clinicianmay also have a means such as user interface 26 to see the patient'sdaily list of media elements to be completed, and may determine wheneach media item was started, stopped, and status (unopened, in progress,complete, etc.). One, some or all of these factors can be used by thehealth care professional in initially designing the patient's care plan,or modifying the care plan after the commencement of the care plan.

The server 22 uses the template to compile a care plan for the patient.The server 22 in one embodiment selects specific content elements 28(videos, surveys, still pictures, audio files, requests for patientinput, personal stories 40, etc.) that will be a part of the patient'scare plan. The server 22 also decides in what general order the contentshould be presented to the patient. It is to be understood, however,that ultimately the care plan designer has the option to order thecontent elements 28 differently, based on type of content, topic, and/orother factors. The care plan designer has the ability to edit mediafiles or the logic branching between files to improve the narratedexperience that accompanies the care plan elements on the patient's userinterface device 12, including the selective presentation of thepersonal story content elements 40. The server 22 in one embodiment isin periodic communication with the set top box 12 of a particularpatient and receives information and feedback about the patient'sprogression through the prescribed material on an on-going basis, andmay select new content elements for presentation to the patient as theybecome appropriate. For example, a diabetic patient may initiallyreceive general and overview information about diabetes, and as thepatient progresses through that material, the server 22 will select moredetailed and specific content directed to the particular patient basedboth on the care plan template and progress and understanding of thepatient. Moreover, the patient may be selectively provided with certainpersonal story content elements 40 that are scheduled in coordinatedfashion with other related content items 28 (e.g., informational and/orsurvey/quiz content 28), and the selection and/or placement of thepersonal story content elements 40 in certain implementations can bebased at least partially on the patient's responses to survey/quizquestions, input values relating to the patient's condition, etc.

As further illustrated in FIG. 1, the server 22 includes an itineraryarrangement system or component 32, such as hardware, software, orcombinations thereof, which operates to select content elements 28 andto arrange the content 28 in an ordered presentation for a given patientviewing session. In other possible implementations, an itineraryarrangement system 32 can be provided as part of the user interface 12,and the interface 12 may also comprise a content element storage memory24 holding one or more content items 28 including personal stories 40,as well as preassembled care plans, where the health care provider mayselectively modify the preloaded plans via the interface 26 and thecontent management system 25 through communications across the network20. In such an implementation, the patient may be provided with a settop box 12 preloaded with the content 28 constituting a care plan, withthe health care provider being able to access the interface 12 via thenetwork 20 to make schedule changes, arrange content, download furthercontent to the interface 12, etc.

The apparatus 10 of FIG. 1 thus constitutes a health care apparatusoperative to render audio visual content to a medical patient. Thememory 24 in the server 22 and/or the content storage capacity of thememory 24 in the user interface set top box 12 provide a content elementstorage coupled with the network 20 for storing a plurality of audiovisual content elements 28 including personal story elements 40 to beselectively rendered to a medical patient. An itinerary arrangementsystem 32 of the server 22 or the user interface 12 is operativelycoupled with the content element storage 24 and operates to select oneor more content elements 28 from the content element storage 24including at least one personal story element 40 to be rendered to thepatient in a given viewing session based at least partially on thepatient's medical condition, where the itinerary arrangement system 32is preferably adapted to obtain information regarding the patient'smedical condition from the content element storage in making the contentselection.

The user interface 12 is also coupled with the network 20 and thedisplay device 14, and is operable by the patient to render the selectedcontent elements 28 to the patient via the display device 14. In oneexemplary implementation, moreover, the itinerary arrangement system 32arranges the selected content elements into a serially ordered itineraryfor presentation to the patient with the personal story element(s) 40presented to the patient after an educational content element.Furthermore, the arrangement system 32 may order the content elementssuch that a personal story content element 40 is presented after aninteractive survey/quiz content element, and the personal story contentelements 40 can be selected based at least partially on a patientresponse to an interactive survey or quiz content element 28 in a givenviewing session.

As illustrated and described further with respect to FIGS. 14-16 below,moreover, the itinerary arrangement system 32 may be adapted to allowthe patient to select from a list of interviewees 42 and to select apersonal story content element 40 showing the selected interviewee 42discussing at least one issue related to the patient's medical conditionin order to enhance the patient's experience and the goals of patientlearning and/or behavior modification by having the story presented by aperson having characteristics preferred by a particular patient, forexample, where the interviewees 42 may be characterized by gender, agegroup, language, or other group characteristic.

Referring also to FIGS. 2-4, the present disclosure provides personalstory content elements 40 to a patient to facilitate patient learning,behavior modification, motivation, and the above-described advantages ofpeer feedback and participation in peer group discussions, whileallowing the patient to experience the content in their own home at atime convenient to the patient. Moreover, the apparatus 10 allows thepatient to have the personal story content delivered multiple times asdesired, whereas participation in live on-line or in-person groupdiscussions offers a one-time-only experience.

FIG. 2 illustrates an exemplary method 100 for creating audio visualpersonal story content elements for presentation to a medical patient,FIG. 3 depicts an exemplary method 200 for rendering personal storycontent to a patient, and FIG. 4 illustrates exemplary operation 300 ofthe apparatus of FIG. 1 in a guided encounter. Although the methods 100,200, and 300 are illustrated and described in the form of a series ofacts or events, it will be appreciated that the various methods of thedisclosure are not limited by the illustrated ordering of such acts orevents except as specifically set forth herein. In this regard, exceptas specifically provided hereinafter, some acts or events may occur indifferent order and/or concurrently with other acts or events apart fromthose illustrated and described herein, and not all illustrated stepsmay be required to implement a process or method in accordance with thepresent disclosure. The illustrated methods may be implemented inhardware, software, manually, or combinations thereof, whether in anetwork server 22, in the patient user interface device 12, or in othercomponents of the apparatus 10 or the methods may be implemented indistributed form in two or more components or systems, wherein thedisclosure is not limited to the specific devices, systems,applications, and implementations illustrated and described herein.

The method 100 of FIG. 2 provides for creation of personal story contentelements, wherein a set of predetermined questions is provided at 102that relate to a given medical condition. In one example, a medicalprofessional might generate a list of topics common to a particulardisease or condition at 102, such as diabetes, where an exemplary set oftopical questions might relate to a patient taking his or her own bloodglucose reading by pricking a finger and using a glucometer, withfurther questions relating to the patient adjusting their diet in orderto keep glucose levels within the proper boundaries, and how exerciseaffects glucose levels.

At 104, questions from the set are presented to at least oneinterviewee, and the interviewee responses are recorded at 106. Thequestions can be obtained in a single-interviewee session or a group ofinterviewees can be assembled for recordation of a group discussion witha moderator posing questions and interacting with the group. In oneexample, individual patients are interviewed in their own homes. Inanother example, a group of diabetes patients could be assembled in aroom, along with a moderator, and one or more video camera operators.The moderator in this situation could begin the discussion by askingpeople to relate their experience of taking their glucose reading forthe first time, and following up with questions as to how the patientfelt, whether the patient learned any tricks to make the glucose readingeasier, how they have incorporated the glucose measurements into theirdaily lives, etc. In response, one or more interviewees in the groupwould relate their “personal stories”, which are recorded on video.Because of the setting of the interviews and the personal nature of thequestions, the responses would be extemporaneous and from the heart, andthus believable and effective for educating and motivating otherpatients. Prompting by an experienced moderator can advantageouslyencourage a rich and positive discussion, while focusing the groupdiscussion on a particular topic or medical condition.

While some responses may be very valuable and medically sound, othersmay not. Accordingly, the interviewee responses are edited at 108 tocreate a personal story content element including an interviewee 42shown discussing at least one issue related to a medical condition, asshown below in FIGS. 15 and 16. For instance, the editing at 108 couldinclude removing incorrect or off-topic responses, adjusting the orderof responses from a given interviewee, removing extraneous orunintelligible language, removing or filtering portions where more thanone person is speaking, etc. The editing also preferably involvesremoving the interviewee's name or other identifying information inconforming to applicable personal health information requirements orstandards to protect interviewees from having their identity disclosedby presentation of a finished personal story content element. Theediting, moreover, may include grouping of comment segments according tosubject matter and participant.

It is noted that the interviewee can preferably be a person who has orhad the given medical condition in order to ensure that the responsesare genuine. However, certain responses may not be communicated in aclear manner, or the response may otherwise be unusable while presentinga good story that would benefit subsequent patients. Moreover, theresponse may include personal health information which will not beincluded in a finished personal story content element. In such cases,actors can be employed as interviewees, for instance, to recreate anactual interviewee response in whole or in part, or to restate anoriginal interviewee's personal story for creation of usable audiovisual personal story content elements 40 while maintaining theinterviewee's personal health information confidential. In this respect,it may be desirable to create personal story content using responses ina certain dialect, language, accent, etc., wherein personal storyelements can be replicated or recreated using actors capable ofproducing the desired speech attributes while portraying another(original) interviewee's story and without divulging the realinterviewee's identity.

Other possible embodiments of personal story content elements couldinclude a patient or actor speaking directly to the camera so that thecontent does not appear to be part of an interview response.Alternatively or in combination, an enactment of an event in aninterviewee's life could be recorded and in corporate into a personalstory content element. For example, the interviewee could speak to aninterviewer or to the camera, and the edited video could cut to anenactment of the events being discussed, possibly with the intervieweeshown in the enactment.

In other possible embodiments, the interviewee's response could bepresented, in whole or in part, as text on the display screen, with orwithout the interviewee's photo displayed alongside the text. Anotherpossible implementation could include at least portions of the editedinterviewee's response being rendered in the form of audio-only personalstory elements that could be played while visually rendering anenactment as described above, or text, or other visual content.

At 110 in FIG. 2, the edited content elements are incorporated into theapparatus 10 in FIG. 1, such as by storing the personal story contentelements 40 in the content element storage 24 coupled with thecommunications network 20 from which content elements 28 are selectedfor presentation to patients having the given medical condition. In theillustrated implementation, the personal story elements 40 are storedalong with other types of audio visual content elements 28, such aseducational content segments, survey/quiz type interactive contentelements, etc., from which a care program can be constructed for a givenpatient and from which individual viewing sessions can be arranged.

With the content elements 28 stored at 110, one or more content elements28 are selected at 112 from the content element storage 24 based atleast partially on the patient's medical condition, where the selectedcontent elements 28 include at least one personal story element 40 to berendered to the patient in a given viewing session. In this regard, themethod 100 may optionally include obtaining information regarding thepatient's medical condition from the content element storage 24 prior toselecting one or more content elements 28 for inclusion in a givenviewing session. The content elements 28 can also be selected at 110based on other considerations, such as general patient backgroundinformation, the patient's personal information, such as age, gender,progress through a defined care plan, and the like.

At 114, the selected content elements 28 are arranged into a seriallyordered itinerary for presentation to the patient. As described above,the ordering of the content elements 28 at 114 may be an initialordering subject to modification as a viewing session progresses, forexample, wherein certain patient responses may trigger the arrangementsystem 32 to select a specific personal story content element 40 forpresentation to the patient. For example, if a patient enters anincorrect answer to a survey or quiz element question, a specificpersonal story may help to show the patient the correct answer in afriendly way, thus helping to educate the patient while providing thepositive reinforcement of having a person explain an issue or thereasoning behind a given survey response in the form of a personalstory.

Referring also to FIG. 3, the selected content elements 28 are thenrendered or displayed to the patient generally at 200 via the displaydevice 14 associated with the user interface 12 (FIG. 1), beginning at202. In the example of FIG. 3, educational content elements 28 arerendered initially to the patient at 204, optionally followed bypresentation of an interactive survey/quiz type content element 28 at206. At 208, the user may optionally select from a listing of possiblestory tellers (e.g., see also FIG. 17 below), after which one or morepersonal story content elements 40 are rendered to the patient at 210,and the content presentation is finished at 212. In the simplifiedexample of FIG. 3, the rendering of the personal story content 40 at 210after the educational content at 204 facilitates improved patientretention and learning of the information provided at 204. Moreover, theprovision of the personal story 40 at 210 following the survey/quizcontent at 206 may advantageously reinforce a correct response to asurvey question and/or may provide a friendly way of correcting anincorrect response to facilitate patient understanding. Moreover, theshort personal story content elements 40 may be interspersed as isbeneficial between informational content and between survey/quizquestions and corresponding patient responses in order to improve theoverall learning, information retention, and motivation for a givenpatient.

In addition to personal stories presented as part of a predefined careprogram, the apparatus 10 of FIG. 1 may further be adapted to allow apatient to access the personal stories 40 via a central menu rendered onthe display device 14. In this implementation, the patient could lookover a series of topics, for instance, the use of a glucometer, andcould also optionally select a person (story teller) that they wouldlike to hear comments from, as shown for example in FIG. 14 below,allowing selection of someone who the patient feels they can relate tobecause of similar age, race, gender, etc. For instance, as shown inFIG. 14, a listing may be constructed with names and/or pictures of thepossible story tellers for which personal story content elements 40 areavailable that pertain to a given patient survey response, episodetopic, etc. In the illustrated example, the patient is presented with alist showing names for the available story tellers, as well as checkboxes allowing patient selection from either “Bill” or “Mary” or “both”.In another possible implementation where multiple story tellers arepossible, a list can be constructed to first allow patient selection ofstory teller age range, gender, region, and/or other characteristics, bywhich the appropriate personal story content element or elements 40 canbe selected for presentation to the patient. Also, the patient may bepresented with the option to listen to all of the stories, or all thestories related to a given topic, or all the stories by a given storyteller, or other options, and the patient may be allowed to view one ormore personal story content elements 40 multiple times if they wish.

Referring now to FIGS. 1 and 4-19, a general description of the overalloperation of the exemplary apparatus 10 is presented in the flow chart300 of FIG. 4, wherein a care plan is initially generated at 302. Beforeor when the patient logs onto the apparatus 10 via the user interface12, the display 14, and the remote control 16, the itinerary arrangementsystem 32 of either the server 22 or the interface device 12 organizescontent at 304 for the current day's viewing by the patient into aserially arranged guided encounter. In one implementation using thearrangement system 32 of the network server 22, the server 22 generatesthe guided encounter at 304 including one or more content elements 28and transmits the plan to the user interface device 12 in advance ofwhen it is scheduled to be viewed, or as it is to be viewed.Alternatively, the set top box interface 12 can be preloaded anddelivered to the patient with a care plan already stored therein. In oneembodiment, the server 22 streams content to the user interface device12 as it is being viewed, or accesses and releases content that ispreloaded or stored on the user interface device 12. In anotherembodiment, an itinerary arrangement processor 32 of the user interface12 is used, where the server 22 transmits the identity of thepreselected content 28 that the patient should view, and the localitinerary arrangement processor 32 in the set top box 12 arranges thecontent into a guided encounter. When the content 28 is stored locallyon the user interface device 12, moreover, the local itineraryarrangement processor 32 takes content that is selected for the presentday's viewing, and arranges it into a simple, easy to understandpresentation in the form of a guided encounter to be viewed on commandby the patient.

Once the content elements have been arranged into a guided encounter forthe patient, the interface device 12 is prepared to present the guidedencounter to the patient. The patient powers up the user interfacedevice 12, and is presented with a welcome screen as shown in FIG. 5,and the patient logs on to the network at 306 by entering a patientidentification code into a log on screen (FIG. 6) using the remotecontrol 16, where the code prevents persons other than the patient fromaccessing the patient's information and programming. The user interfacedevice 12 then presents a welcome screen as shown in FIG. 7 to thepatient via the display 14 for several seconds, followed by presentationat 308 of an itinerary screen (FIG. 8), showing the day's scheduledactivities. This screen gives the patient an idea of the amount ofmaterial that will be covered, where the itinerary may be summarizedorally and visually by a nurse narrator and may optionally provideapproximate time durations of the material to be presented such that apatient or user can schedule or plan his or her day.

At 310, the user interface 12 prompts the patient to begin thepresentation, such as by pressing any key 18 on the remote 16 at 312. Asshown in FIG. 9, an overview of the first content element is presented,such as showing the title of a video element 28 about hypoglycemia,where the overview screen may include the expected video duration,details about topics covered, etc. The patient then selects to proceedat 312 (FIG. 4), such as by pressing any key 18, and the user interface12 renders the first content element 28 at 314, such as a hypoglycemiavideo depicted in FIG. 10. At 315, a determination may be made as towhether the current content element 28 is an interactive survey/quiztype element, and if not (e.g., NO at 315 for an educational contentelement 28), the patient may be offered the option to save the contentelement 28 for later review at 316 from a save screen (FIG. 11).Thereafter, the patient is returned to the itinerary screen (FIG. 12) at318, where the screen may include check marks as shown or other indiciaindicating to the patient their relative progress through the material.

The user interface device 12 makes a determination at 320 as to whetherthere are additional content elements 28 remaining for presentation tothe patient in the guided encounter, and if so (YES at 320), returns to310 and prompts the user to indicate when they are ready to start thenext content element 28, such as by pressing any key 18 on the remotecontroller 16. This process continues at 310-315 as described above,wherein the next element 28 in the illustrated example is a survey orquestionnaire or quiz element 28 in which the patient enters one or moreresponses (YES at 315). As shown in FIG. 13, a survey/quiz screen ispresented which requests the patient to answer a question, in thisexample, after watching the hypoglycemia video. Once the patientprovides answers to the survey using the remote 16, the user interfacedevice 12 determines at 328 whether the patient response is correct. Ifnot (NO at 328), appropriate portions of the preceding educationalcontent element 28 may be reviewed at 330, and otherwise, (YES at 328),the user interface returns to the itinerary screen at 318. At 320, theuser interface 12 again checks if there is any remaining content.

In the illustrated example, the itinerary screen then indicates that thenext content element 28 is a personal story 40, which may have beenpreselected or may be selected based at least partially on the patient'sresponse to the survey/quiz content 28. In this implementation,moreover, the patient is presented with a story teller selection screen(FIG. 14) at 310, in this case, to select from a first story teller“Bill” or a second story teller “Mary”, or to select to hear personalstories 40 from both. The personal story content elements 40 are thenrendered to the patient at 314, wherein FIG. 15 illustrates an initialpersonal story being told to the patient by Bill 42, and FIG. 16 showsanother personal story being told by Mary 42.

Once all the scheduled content elements 28 have been presented (NO at320), the user interface 12 displays an end dialog screen at 322 thatcongratulates the patient on a successful completion of the guidedencounter, an example of which is shown in FIG. 17, after which thepatient can press any key 18 to go to a general navigational menu at 324(FIG. 18) allowing selection of other activities and functions of thesystem other than those required in the current day's itinerary, and thepatient can provide the apparatus 10 with feedback on their own personalgoals concerning what they would like to accomplish, as depicted in FIG.19 or can log off at 326.

The above described examples are merely illustrative of several possibleembodiments of the present disclosure, wherein equivalent alterationsand/or modifications will occur to others skilled in the art uponreading and understanding this specification and the annexed drawings.In particular regard to the various functions performed by the abovedescribed components (assemblies, devices, systems, circuits, and thelike), the terms (including a reference to a “means”) used to describesuch components are intended to correspond, unless otherwise indicated,to any component, such as hardware, software, or combinations thereof,which performs the specified function of the described component (i.e.,that is functionally equivalent), even though not structurallyequivalent to the disclosed structure which performs the function in theillustrated implementations of the disclosure. In addition, although aparticular feature of the disclosure may have been disclosed withrespect to only one of several embodiments, such feature may be combinedwith one or more other features of the other implementations as may bedesired and advantageous for any given or particular application. Also,to the extent that the terms “including”, “includes”, “having”, “has”,“with”, or variants thereof are used in the detailed description and/orin the claims, such terms are intended to be inclusive. It will beappreciated that various of the above-disclosed and other features andfunctions, or alternatives thereof, may be desirably combined into manyother different systems or applications, and further that variouspresently unforeseen or unanticipated alternatives, modifications,variations or improvements therein may be subsequently made by thoseskilled in the art which are also intended to be encompassed by thefollowing claims.

Having thus described the preferred embodiments, the invention is nowclaimed to be:
 1. A health care apparatus to render audio visual contentto a medical patient, comprising: a content element storage coupled witha communications network and adapted to store a plurality of audiovisual content elements to be rendered to a medical patient, theplurality of audio visual content elements including a plurality ofeducational content elements and a plurality of personal story elements,each personal story element including an interviewee shown discussing atleast one issue related to a medical condition and wherein theeducational content elements include different content from the personalstory elements; an itinerary arrangement system operatively coupled withthe content element storage and adapted to select one or more contentelements from the content element storage including at least one of theplurality of educational content elements and at least one of theplurality of personal story elements to be rendered to the patient in agiven viewing session based at least partially on the patient's medicalcondition, wherein the itinerary arrangement system orders the at leastone of the plurality of educational content elements for rendering tothe medical patient before the at least one of the plurality of personalstory elements; and a user interface operatively coupled with thecommunications network and with a display device, the user interfacebeing operable by the patient to render the selected content elements tothe patient via the display device.
 2. The health care apparatusaccording to claim 1, wherein the content element storage is located inthe user interface.
 3. The health care apparatus according to claim 1,wherein the itinerary arrangement system is located in the userinterface.
 4. The health care apparatus according to claim 1, whereinthe itinerary arrangement system selects the at least one of theplurality of personal story elements and at least one of the pluralityof educational content elements to be rendered to the patient in a givenviewing session based at least partially on the patient's medicalcondition, and wherein the itinerary arrangement system arranges theselected content elements into a serially ordered itinerary forpresentation to the patient with the personal story element presented tothe patient after the educational content element.
 5. The health careapparatus according to claim 1, wherein the itinerary arrangement systemselects the at least one of the plurality of personal story elements andat least one interactive survey or quiz content element to be renderedto the patient in a given viewing session based at least partially onthe patient's medical condition, and wherein the itinerary arrangementsystem arranges the selected content elements into a serially ordereditinerary for presentation to the patient with the personal storyelement presented to the patient after the interactive survey or quizcontent element.
 6. The health care apparatus according to claim 5,wherein the itinerary arrangement system selects the at least onepersonal story element based at least partially on a patient response tothe interactive survey or quiz content element in the viewing session.7. The health care apparatus according to claim 1, wherein the itineraryarrangement system is adapted to obtain information regarding thepatient's medical condition from the content element storage to selectone or more content elements from the content element storage to berendered to the patient in a given viewing session.
 8. A method ofrendering health care information to a patient, comprising: storing, bya server, a plurality of audio visual content elements to be rendered toa medical patient, the plurality of audio visual content elementsincluding a plurality of educational content elements and a plurality ofpersonal story elements, each personal story element including aninterviewee shown discussing at least one issue related to a medicalcondition and wherein the educational content elements include differentcontent from the personal story elements; selecting, by the server, oneor more stored content elements based at least partially on thepatient's medical condition, the selected content elements including atleast one of the plurality educational content elements and at least oneof the plurality of personal story elements to be rendered to thepatient in a given viewing session; and rendering, by a display device,a display of the selected content elements to the patient, wherein therendering includes displaying the at least one of the plurality ofeducational content elements before the at least one of the plurality ofpersonal story elements.
 9. The method according to claim 8, wherein theone or more selected stored content elements are transferred to apatient's home for display.
 10. The method according to claim 8, whereinselecting one or more content elements includes selecting at least oneof the plurality of personal story elements and at least one of theplurality of educational content elements to be rendered to the patientin a given viewing session, and further including arranging the selectedcontent elements into a serially ordered itinerary for presentation tothe patient.
 11. The method according to claim 8, wherein selecting oneor more content elements includes selecting at least one of theplurality of personal story elements and at least one of the pluralityof educational content elements or interactive survey or quiz contentelement to be rendered to the patient in a given viewing session basedat least partially on the patient's medical condition, and furtherincluding arranging the selected content elements into a seriallyordered itinerary for presentation to the patient with the personalstory element presented to the patient after the educational contentelement or the interactive survey or quiz content element.
 12. Themethod according to claim 8, wherein selecting one or more contentelements includes selecting at least interactive survey content elementand selecting at least one personal story element based at leastpartially on a patient response to the interactive survey contentelement in the viewing session.
 13. The method according to claim 12,wherein selecting one or more content elements includes incorporating atleast one personal story content element into a defined care plan. 14.The method according to claim 13, further including arranging theselected content elements into a serially ordered itinerary with the atleast one personal story content element arranged to correspond to achronology of the defined care plan.
 15. The method according to claim8, further comprising obtaining information regarding the patient'smedical condition prior to selecting the one or more content elements.16. The method according to claim 8, further comprising: generating aset of questions relating to a given medical condition; presentingquestions from the set to at least one interviewee; recording theinterviewee's responses to the presented questions; editing theinterviewee's responses to create a personal story content element; andstoring the personal story content element.
 17. The method according toclaim 16, comprising: gathering a plurality of interviewees in a groupsession; presenting questions from the set to two or more of theinterviewees; recording responses by two or more of the interviewees;and editing the responses to create at least one personal story contentelement.
 18. The method according to claim 8, wherein selecting one ormore content elements includes allowing the patient to select from alist of interviewees and selecting a personal story content elementshowing the selected interviewee discussing at least one issue relatedto the patient's medical condition.
 19. The method according to claim 8,further comprising determining an availability of one or more personalstory content elements based on personal information other than thepatient's medical condition.
 20. A non-transitory computer readablemedium or processor programmed to implement a method of rendering healthcare information to a patient, the method comprising: storing aplurality of audio visual content elements to be rendered to a medicalpatient, the plurality of audio visual content elements including aplurality of educational content elements and a plurality of personalstory elements, each personal story element including an intervieweeshown discussing at least one issue related to a medical condition andwherein the educational content elements include different content fromthe personal story elements; selecting one or more stored contentelements based at least partially on the patient's medical condition,the selected content elements including at least one of the educationalcontent elements and at least one of the plurality of personal storyelements to be rendered to the patient in a given viewing session; andrendering a display of the selected content elements to the patient,wherein the rendering includes displaying the at least one of theplurality of educational content elements before the at least one of theplurality of personal story elements.
 21. A method of rendering healthcare information to a patient, comprising: recording, by a recordingdevice, at least one interviewee's responses to at least one questionrelated to a given medical condition; editing the interviewee'sresponses to create a personal story content element showing theinterviewee discussing the given medical condition; storing, by aserver, an audio visual content element to be rendered to a medicalpatient, the audio visual content element including an educationalcontent element and the personal story content element, the personalstory content element including the interviewee shown discussing atleast one issue related to the given medical condition and wherein theeducational content element includes different content from the personalstory content element; selecting, by the server, the audio visualcontent element including the educational content element and thepersonal story content element to be rendered to the patient in a givenviewing session based at least partially on the patient's medicalcondition; and rendering, by a display device, a display of the selectedaudio visual content element to the patient, wherein the renderingincludes displaying the educational content element before the personalstory element.
 22. The method according to claim 21, wherein selectingthe audio visual content element includes incorporating the personalstory content element into a defined care plan.
 23. The method accordingto claim 22, further including arranging the selected audio visualcontent element into a serially ordered itinerary with the personalstory content element arranged to correspond to a chronology of thedefined care plan.
 24. The method according to claim 21, furthercomprising allowing the patient to select from a list of intervieweesincluding the at least one interviewee, and selecting the personal storycontent element showing the at least one interviewee discussing the atleast one issue related to the patient's medical condition.